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MASSACHUSETTS EYE AND EAR INFIRMARY MEDICAL PLAN 401k Plan overview

Plan NameMASSACHUSETTS EYE AND EAR INFIRMARY MEDICAL PLAN
Plan identification number 504

MASSACHUSETTS EYE AND EAR INFIRMARY MEDICAL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental
  • Other welfare benefit cover

401k Sponsoring company profile

MASSACHUSETTS EYE AND EAR INFIRMARY has sponsored the creation of one or more 401k plans.

Company Name:MASSACHUSETTS EYE AND EAR INFIRMARY
Employer identification number (EIN):042103591
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MASSACHUSETTS EYE AND EAR INFIRMARY MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042018-01-01
5042017-01-01DIANA KELLER DIANA KELLER2018-07-18
5042016-02-01DIANA KELLER DIANA KELLER2017-09-18
5042015-02-01DIANA KELLER DIANA KELLER2016-08-18
5042014-02-01DIANA KELLER
5042013-02-01DIANA KELLER
5042012-02-01DIANA KELLER
5042011-02-01DIANA KELLER
5042009-02-01DIANA KELLER

Plan Statistics for MASSACHUSETTS EYE AND EAR INFIRMARY MEDICAL PLAN

401k plan membership statisitcs for MASSACHUSETTS EYE AND EAR INFIRMARY MEDICAL PLAN

Measure Date Value
2018: MASSACHUSETTS EYE AND EAR INFIRMARY MEDICAL PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-011,487
Total number of active participants reported on line 7a of the Form 55002018-01-010
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-010
2017: MASSACHUSETTS EYE AND EAR INFIRMARY MEDICAL PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-011,402
Total number of active participants reported on line 7a of the Form 55002017-01-011,471
Number of retired or separated participants receiving benefits2017-01-0116
Total of all active and inactive participants2017-01-011,487
Total participants2017-01-011,487
2016: MASSACHUSETTS EYE AND EAR INFIRMARY MEDICAL PLAN 2016 401k membership
Total participants, beginning-of-year2016-02-011,472
Total number of active participants reported on line 7a of the Form 55002016-02-011,382
Number of retired or separated participants receiving benefits2016-02-0120
Total of all active and inactive participants2016-02-011,402
Total participants2016-02-011,402
2015: MASSACHUSETTS EYE AND EAR INFIRMARY MEDICAL PLAN 2015 401k membership
Total participants, beginning-of-year2015-02-011,469
Total number of active participants reported on line 7a of the Form 55002015-02-011,464
Number of retired or separated participants receiving benefits2015-02-018
Total of all active and inactive participants2015-02-011,472
Total participants2015-02-011,472
2014: MASSACHUSETTS EYE AND EAR INFIRMARY MEDICAL PLAN 2014 401k membership
Total participants, beginning-of-year2014-02-011,324
Total number of active participants reported on line 7a of the Form 55002014-02-011,457
Number of retired or separated participants receiving benefits2014-02-0112
Number of other retired or separated participants entitled to future benefits2014-02-010
Total of all active and inactive participants2014-02-011,469
2013: MASSACHUSETTS EYE AND EAR INFIRMARY MEDICAL PLAN 2013 401k membership
Total participants, beginning-of-year2013-02-011,710
Total number of active participants reported on line 7a of the Form 55002013-02-011,309
Number of retired or separated participants receiving benefits2013-02-0115
Number of other retired or separated participants entitled to future benefits2013-02-010
Total of all active and inactive participants2013-02-011,324
2012: MASSACHUSETTS EYE AND EAR INFIRMARY MEDICAL PLAN 2012 401k membership
Total participants, beginning-of-year2012-02-011,667
Total number of active participants reported on line 7a of the Form 55002012-02-011,690
Number of retired or separated participants receiving benefits2012-02-0120
Number of other retired or separated participants entitled to future benefits2012-02-010
Total of all active and inactive participants2012-02-011,710
2011: MASSACHUSETTS EYE AND EAR INFIRMARY MEDICAL PLAN 2011 401k membership
Total participants, beginning-of-year2011-02-011,633
Total number of active participants reported on line 7a of the Form 55002011-02-011,650
Number of retired or separated participants receiving benefits2011-02-0117
Number of other retired or separated participants entitled to future benefits2011-02-010
Total of all active and inactive participants2011-02-011,667
2009: MASSACHUSETTS EYE AND EAR INFIRMARY MEDICAL PLAN 2009 401k membership
Total participants, beginning-of-year2009-02-011,360
Total number of active participants reported on line 7a of the Form 55002009-02-011,359
Number of retired or separated participants receiving benefits2009-02-0116
Number of other retired or separated participants entitled to future benefits2009-02-010
Total of all active and inactive participants2009-02-011,375

Form 5500 Responses for MASSACHUSETTS EYE AND EAR INFIRMARY MEDICAL PLAN

2018: MASSACHUSETTS EYE AND EAR INFIRMARY MEDICAL PLAN 2018 form 5500 responses
2018-01-01Type of plan entityMulitple employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingYes
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: MASSACHUSETTS EYE AND EAR INFIRMARY MEDICAL PLAN 2017 form 5500 responses
2017-01-01Type of plan entityMulitple employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: MASSACHUSETTS EYE AND EAR INFIRMARY MEDICAL PLAN 2016 form 5500 responses
2016-02-01Type of plan entityMulitple employer plan
2016-02-01Submission has been amendedNo
2016-02-01This submission is the final filingNo
2016-02-01This return/report is a short plan year return/report (less than 12 months)Yes
2016-02-01Plan is a collectively bargained planNo
2016-02-01Plan funding arrangement – InsuranceYes
2016-02-01Plan funding arrangement – General assets of the sponsorYes
2016-02-01Plan benefit arrangement – InsuranceYes
2016-02-01Plan benefit arrangement – General assets of the sponsorYes
2015: MASSACHUSETTS EYE AND EAR INFIRMARY MEDICAL PLAN 2015 form 5500 responses
2015-02-01Type of plan entityMulitple employer plan
2015-02-01Submission has been amendedNo
2015-02-01This submission is the final filingNo
2015-02-01This return/report is a short plan year return/report (less than 12 months)No
2015-02-01Plan is a collectively bargained planNo
2015-02-01Plan funding arrangement – InsuranceYes
2015-02-01Plan funding arrangement – General assets of the sponsorYes
2015-02-01Plan benefit arrangement – InsuranceYes
2015-02-01Plan benefit arrangement – General assets of the sponsorYes
2014: MASSACHUSETTS EYE AND EAR INFIRMARY MEDICAL PLAN 2014 form 5500 responses
2014-02-01Type of plan entityMulitple employer plan
2014-02-01Submission has been amendedNo
2014-02-01This submission is the final filingNo
2014-02-01This return/report is a short plan year return/report (less than 12 months)No
2014-02-01Plan is a collectively bargained planNo
2014-02-01Plan funding arrangement – InsuranceYes
2014-02-01Plan funding arrangement – General assets of the sponsorYes
2014-02-01Plan benefit arrangement – InsuranceYes
2014-02-01Plan benefit arrangement – General assets of the sponsorYes
2013: MASSACHUSETTS EYE AND EAR INFIRMARY MEDICAL PLAN 2013 form 5500 responses
2013-02-01Type of plan entityMulitple employer plan
2013-02-01Submission has been amendedNo
2013-02-01This submission is the final filingNo
2013-02-01This return/report is a short plan year return/report (less than 12 months)No
2013-02-01Plan is a collectively bargained planNo
2013-02-01Plan funding arrangement – InsuranceYes
2013-02-01Plan funding arrangement – General assets of the sponsorYes
2013-02-01Plan benefit arrangement – InsuranceYes
2013-02-01Plan benefit arrangement – General assets of the sponsorYes
2012: MASSACHUSETTS EYE AND EAR INFIRMARY MEDICAL PLAN 2012 form 5500 responses
2012-02-01Type of plan entityMulitple employer plan
2012-02-01Submission has been amendedNo
2012-02-01This submission is the final filingNo
2012-02-01This return/report is a short plan year return/report (less than 12 months)No
2012-02-01Plan is a collectively bargained planNo
2012-02-01Plan funding arrangement – InsuranceYes
2012-02-01Plan funding arrangement – General assets of the sponsorYes
2012-02-01Plan benefit arrangement – InsuranceYes
2012-02-01Plan benefit arrangement – General assets of the sponsorYes
2011: MASSACHUSETTS EYE AND EAR INFIRMARY MEDICAL PLAN 2011 form 5500 responses
2011-02-01Type of plan entityMulitple employer plan
2011-02-01Submission has been amendedNo
2011-02-01This submission is the final filingNo
2011-02-01This return/report is a short plan year return/report (less than 12 months)No
2011-02-01Plan is a collectively bargained planNo
2011-02-01Plan funding arrangement – InsuranceYes
2011-02-01Plan funding arrangement – General assets of the sponsorYes
2011-02-01Plan benefit arrangement – InsuranceYes
2011-02-01Plan benefit arrangement – General assets of the sponsorYes
2009: MASSACHUSETTS EYE AND EAR INFIRMARY MEDICAL PLAN 2009 form 5500 responses
2009-02-01Type of plan entityMulitple employer plan
2009-02-01Submission has been amendedNo
2009-02-01This submission is the final filingNo
2009-02-01This return/report is a short plan year return/report (less than 12 months)No
2009-02-01Plan is a collectively bargained planNo
2009-02-01Plan funding arrangement – InsuranceYes
2009-02-01Plan funding arrangement – General assets of the sponsorYes
2009-02-01Plan benefit arrangement – InsuranceYes
2009-02-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
Policy contract number0318451
Policy instance 1
Insurance contract or identification number0318451
Number of Individuals Covered2332
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $19,306
Total amount of fees paid to insurance companyUSD $13,392
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,306
Amount paid for insurance broker fees13392
Additional information about fees paid to insurance brokerBONUS AND NON MONETARY COMMISSION
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
Policy contract number0318451
Policy instance 1
Insurance contract or identification number0318451
Number of Individuals Covered1200
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $31,320
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,595
Amount paid for insurance broker fees11536
Additional information about fees paid to insurance brokerBONUS AND PERSISTENCY COMMISSION
Insurance broker organization code?3
Insurance broker nameBROWN & BROWN OF MA, LLC

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